Anxiety, depression and low self-esteem among people with alopecia
Main Article Content
Abstract
OBJECTIVES: To assess the frequency of anxiety and depression symptoms among individuals with alopecia and to assess the self-esteem levels of alopecia patients in a hair restorative treatment center of Karachi, Pakistan.
METHODS: This cross-sectional study was conducted on 84 consecutive patients of Alopecia by conducting interviews. Sample size was calculated using the prevalence rate of alopecia of 2% at confidence level of 95% and precision of 3%. Hospital Anxiety and Depression Scale (HADS) which was used to quantify depression and anxiety, and Rosenberg Self-esteem Scale (RSES) was used for self- esteem levels. Scores were calculated. Test of correlation and Chi square test were applied.
RESULTS: Median (inter-quartile range) HADS score for Anxiety and Depression in 84 study participants was 11 (7-14) and 11 (8-14) respectively. Regarding depression and depression, 52.4% (n=44) and 53.6% (n=45) fell into the abnormal category (score 11-21) respectively. For self-esteem, 48.8% (n=41) had low self-esteem (score 0-14). Positive correlation was found between age of participants and their self- esteem score (p- value =0.001). The older participants achieved higher scores. There was an inverse relation between age at onset of alopecia and self-esteem score (p-value= 0.03). People with early onset of Alopecia had lower self-esteem scores. There was no significant difference between male and females and the anxiety, depression and self-esteem levels.
CONCLUSION: Our study reveals significant prevalence of depression, anxiety, and low self-esteem among alopecia patients seeking hair restoration, highlighting the urgent need for targeted psychological interventions.
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References
Anon. Alopecia. [internet] The Free Dictionary. 2012 [Accessed on: February 15, 2023]. Available from URL: https://medical-dictionary.thefreedictionary.com/alopecia
Gokalp H. Psychosocial Aspects of Hair Loss [Internet]. Hair and Scalp Disorders. InTech; 2017 [Accessed on: February 15, 2023]. Available from URL: http://dx.doi.org/10.5772/66156
Singh K, Saeed F, Ahmad Z, Ahsan F, Shakya P. Alopecia: introduction and overview of herbal treatment. J Chem Pharm Res 2016;8(8):59-64.
Lee HH, Gwillim E, Patel KR, Hua T, Rastogi S, Ibler E et al. Epidemiology of alopecia areata, ophiasis, totalis, and universalis: A systematic review and meta-analysis. J Am Acad Dermatol 2020;82(3):675-82. https://doi.org/10.1016/j.jaad.2019.08.032
Amoretti A, Laydner H, Bergfeld W. Androgenetic alopecia and risk of prostate cancer: a systematic review and meta-analysis. J Am Acad Dermatol 2013;68(6):937-43. https://doi.org/10.1016/J.JAAD.2012.11.034
Foundation BS. Traction alopecia. [Internet]. British Skin Foundation. 2022 [Accessed on: February 15, 2023]. Available from URL: https://knowyourskin.britishskinfoundation.org.uk/condition/traction-alopecia/
Pradhan P, D’Souza M, Bade BA, Thappa DM, Chandrashekar L. Psychosocial impact of cicatricial alopecias. Indian J Dermatol 2011;56(6):684. https://doi.org/10.4103/0019-5154.91829
Ghajarzadeh M, Ghiasi M, Kheirkhah S. Depression and quality of life in Iranian patients with Alopecia Areata. Iran J Dermatol 2011;14(4):140-3.
Marks DH, Penzi LR, Ibler E, Manatis-LA, Hagigeorges D, Yasuda M et al. The medical and psychosocial associations of alopecia: recognizing hair loss as more than a cosmetic concern. Am J Clin Dermatol 2019;20:195-200. https://doi.org/10.1007/S40257-018-0405-2
Hunt N, McHale S. Reported experiences of persons with alopecia areata. J Loss Trauma 2004;10(1):33-50. https://doi.org/10.1080/15325020490890633
Baghestani S, Zare S, Seddigh SH. Severity of depression and anxiety in patients with alopecia areata in Bandar Abbas, Iran. Dermatol Reports 2015;7(3). https://doi.org/10.4081/DR.2015.6063
Chu SY, Chen YJ, Tseng WC, Lin MW, Chen TJ, Hwang CY et al. Psychiatric comorbidities in patients with alopecia areata in Taiwan: a case–control study. Br J Dermatol 2012;166(3):525-31. https://doi.org/10.1111/J.1365-2133.2011.10714.X
Rafique R, Hunt N. Experiences and coping behaviours of adolescents in Pakistan with alopecia areata: An interpretative phenomenological analysis. Int J Qual Stud Health Well-being 2015;10(1):26039. https://doi.org/10.3402/QHW.V10.26039
Marahatta S, Agrawal S, Adhikari BR. Psychological impact of alopecia areata. Dermatol Res Pract 2020;2020:8879343. https://doi.org/10.1155/2020/8879343
Billy. The Hospital Anxiety and Depression Scale [Internet]. Dreams to Realities. 2018 [Accessed on: February 15, 2023]. Available from URL: http://dreamstorealities.co.uk/hads-self-test-questionnaire/
Rosenberg M. Rosenberg Self Esteem Scale [Internet]. American Psychological Association. [Accessed on: February 15, 2023]. Available from URL: https://www.apa.org/obesity-guideline/rosenberg-self-esteem.pdf
Snaith RP. The hospital anxiety and depression scale. Health and quality of life outcomes. 2003;1(1):1-4. https://doi.org/10.1186/1477-7525-1-29
Mansoor H. “Depression rising alarmingly in Pakistan’s urban areas” [Internet]. DAWN.COM. 2017 [Accessed on: February 15, 2023]. Available from URL: https://www.dawn.com/news/1325360
Godil A, Mallick MS, Adam AM, Haq A, Khetpal A, Afzal R, et al. Prevalence and severity of depression in a Pakistani population with at least one major chronic disease. J Clin Diagnostic Res 2017;11(8):OC05. https://doi.org/10.7860/JCDR/2017/27519.10329
F Farooq S, Khan T, Zaheer S, Shafique K. Prevalence of anxiety and depressive symptoms and their association with multimorbidity and demographic factors: a community-based, cross-sectional survey in Karachi, Pakistan. BMJ Open 2019;9(11):e029315. https://doi.org/10.1136/BMJOPEN-2019-029315
Uhlenbusch N, Löwe B, Härter M, Schramm C, Weiler-Normann C, Depping MK. Depression and anxiety in patients with different rare chronic diseases: A cross-sectional study. PLoS One 2019;14(2):e0211343. https://doi.org/10.1371/JOURNAL.PONE.0211343
Chikere IC, Ugonma WD, Somtochukwu MO, Angela JO, Uchenna LI, Queen K, et al. Prevalence of perceived depression and anxiety among hypertensives attending imo specialist hospital Owerri, Nigeria. Arch Depress Anxiety 2020;45-9. https://doi.org/10.17352/2455-5460.000051
Liu F, Miao Y, Li X, Qu Q, Liu Y, Li K, et al. The relationship between self‐esteem and hair transplantation satisfaction in male androgenetic alopecia patients. J Cosmet Dermatol 2019;18(5):1441-7. https://doi.org/10.1111/JOCD.12839
Aşkın Ö, Koyuncu Z, Serdaroğlu S. Association of alopecia with self-esteem in children and adolescents. Int J Adolesc Med Health 2020;34(5):315-8. https://doi.org/10.1515/IJAMH-2020-0100
Teichgräber F, Jacob L, Koyanagi A, Shin JI, Seiringer P, Kostev K. Association between skin disorders and depression in children and adolescents: A retrospective case-control study. J Affect Disord 2021;282:939-44. https://doi.org/10.1016/J.JAD.2021.01.002